How do you design a better patient chair? For us it began with conversations, more than 200 of them. We spoke with caregivers, patients, and other support personnel to find out what works and what doesn’t. We also consulted with ergonomists, physical therapists, and gerontologists to understand the recovery process. We learned a lot, and the resulting design became the Nala Chair.

Patients need to be comfortable—physically as well as emotionally. One way the Nala Chair addresses this is by mimicking the natural movement of a person’s body: tilting and pivoting at the ankle, knee, and hip. The motion of the chair is relaxed and controlled; heavier patients will not recline too quickly and lighter ones will not move forward too quickly. Nala’s arms, long and wide, provide patients with ample place to grip while getting in and out of the chair—ensuring patients feel secure.

For caregivers, transferring seated patients up and out of a chair can be a strenuous task. To assist them, Nala was designed with a leaf spring to reduce the physical effort needed to move a patient. To simplify cleaning, Nala was designed with sizeable gaps between components to minimize debris build-up. Resilient materials and finishes were selected to stand up to the rigors of healthcare environments.

We believe that design is a process that begins with people. That’s why we talk to the right people, ask lots of questions, and listen carefully to their answers. The results of these conversations, as in the case of Nala, can be comfortable and healthy.

In healthcare, serving people means giving special attention to patients, nurses, doctors, and other people involved in the continuum of care. Herman Miller does this by understanding and empathizing with each person’s experience. We then do our best to share these insights with product development teams through reports, hallway conversations, and workshops. The results become the award-winning designs like the Oasis Overbed Table and Compass System.

Our people-approach to design was recently recognized by Planetree, a nonprofit and long-time advocate of patient-centered care. Invited to become a member of their Planetree Visionary Design Network (PVDN), Herman Miller works with the organization and its partners to inspire and create healing spaces that begin with people.

Pitt County Memorial Hospital Chapel, a LS3P project. Photo: Mark Herboth

Just like any good design, the best examples of healthcare architecture are human-centered and problem solving. Marc Marchant, Vice President and Principal with Charleston, South Carolina-based LS3P Associates, recently spoke with Discover about the complicated yet rewarding world of healthcare design. Marchant, a thirteen-year industry veteran, is a former recipient of the Herman Miller Health Care and American Institute of Architects’ Healthcare Interns Scholarship.

What are a few of the challenges unique to designing spaces for healthcare?
In healthcare, there are complicated buildings that require a very solution-based outcome—not just for the building, but for the patients and staff. How do you create a building that comforts patients, creates a meaningful work environment for staff and is extremely functional? How do you take something as mundane as an MRI room and create a space that is conducive to keeping patients calm during an otherwise unnerving procedure?

How do you work with a client to help them stay true to their vision?
The design and construction process can take years, so it starts with the design team and owner collaborating to establish the big vision and always looking back at that big idea to make sure they are achieving it. Everyone needs to have buy-in from the beginning to achieve the vision.

What’s the role of sustainability in healthcare design?
Fundamentally, the tenants of sustainability help us create buildings that are healthier for people and for the environment. The good news is that in healthcare design, many products and installation methods support sustainability as a baseline. The industry demands it because it’s the right thing to do. Some of the challenges include water use and mechanical design, all of which can be achievable in hospitals. Our role as designers is to communicate the benefit analysis for our clients.

Tell us about a project you were proud to be a part of.
One of the things I appreciate about healthcare design is that the half-million dollar projects are just as important as a $50 million project in terms of applying good healthcare practices. About three years ago, LS3P completed the design for Hampton Regional Medical Center, a replacement hospital in a rural county in South Carolina. The biggest challenge was to support the CEO’s vision, which was to maintain the health center for the county, to grow its support to the community, and to magnetize an affiliation with a larger medical system.

We’re real proud of the results. The new hospital is a beacon in the community; it’s welcoming and accommodating, with expanded, state-of-the-art services to attract doctors and nurses. It has become a place of gathering for the community, and a large healthcare system in Charleston is now affiliated with it. The story was less about architecture and more about how good design and really listening to your clients can create a positive outcome for the community.

Physicians and nurses work through a space planning exercise. Photo: Joint Commission Resources

The design process can be overwhelming if you’re unfamiliar with its various phases, tools, and lingo. A new workshop aims to give healthcare professionals the skills to positively influence patient safety and quality during the design and construction of future healthcare environments.

Learning to read blueprints, articulate a future vision, and design for flexibility, these and other skills are covered in the Safe Health Design Learning Academy. This three-day session is organized by Joint Commission Resources (JCR)—a not-for-profit healthcare accreditation organization—and sponsored by Herman Miller.

Giving physicians, nurses, and healthcare leadership an active voice in the design of healthcare will result in safer spaces, better patient care, and satisfied caregivers—all noble goals.

The next JCR Safe Health Design Learning Academy will be held in April 23-25, 2012; sign up now.

“If we think about architecture as simply beautiful objects,” says Michael Murphy, founding partner of Mass Design Group, “then we fail to talk about the process which creates those objects. It’s labor—the construction of craft—that produces beauty.”

Consider Butaro Hospital in Rwanda, an example of MASS Design’s belief in first-rate healthcare facilities for the third world and investing in the local economy as a means of breaking the cycle of poverty. For Butaro’s wall construction, local Rwandans became the masons: hand-chipping volcanic rock and beautifully shaping each piece so they fit together like a jigsaw puzzle.

Built 100 percent by the community, Butaro’s walls are as much symbolic as they are functional. They testify to a community that labored together, using newly learned skills, to build a hospital for themselves.

Patients benefit from their labors, too, in the design of the hospital. Placing beds in the center, making each bed a window seat creates a positive patient experience. An innovative airflow design minimizes the spread of airborne diseases.

Butaro Hospital is functional, innovative, and beautiful. But, to the community, its best design was the process by which it was created.

Herman Miller is excited about working together with MASS. Learn more here.

The paint has dried and the doors have opened on a new Herman Miller Healthcare Customer Experience Center that engages and inspires.

To engage visitors, we designed plenty of hands-on experiences. We encourage customers to  interact with and experiment with products. Visitors can try the Oasis overbed table while lying in bed. They can rearrange the modular tiles of the Compass System and see first-hand the Herman Miller Performance System.

Inspiration comes in the form of settings—from waiting rooms, to patient rooms, as well as laboratories. Visitors see thoughtful, realistic solutions to their problems, as well as many that really make them think.

Engaging and inspiring, the aim of our Customer Experience Center is to help people realize the power of space.

Gianfranco Zaccai pretends to be a lot of things: Chinese parent, a basketball player, and a child with diabetes to name a few. When asked to work on a healthcare project, Zaccai and his team at Continuum, the design consultancy he co-founded, built a fake hospital room and pretended to be hospital patients. Why? “To empathize,” replied Zaccai in a recent Wall Street Journal article.

Zaccai isn’t interested in producing a “better” healthcare product—his goal is to create a better healthcare experience. Which is exactly what he and Continuum achieved in the Compass modular furniture system for Herman Miller Healthcare. More than 550 clinicians, hospital administrators, architects, and designers were interviewed to find the most important unmet needs in how patient and exam rooms are designed now. The result was a deep understanding of what makes a better experience for everyone involved: the patient, the caregiver, the family, and the administrator. Because, as Zaccai says, “The opportunity for innovation is finding the sweet spot where needs overlap.”

Good design addressed needs, and in healthcare—where patients, nurses, doctors, and support staff are all interacting in one environment—there are a lot of people with a lot of different needs. Gary Cruce, design principle at Nemschoff, understands this and the award-winning Oasis overbed table is a result.

Gary and I recently had an opportunity to talk about the design of Oasis.

What are some of the issues relating to overbed tables?

There are a lot of different people competing for the same small space on an overbed table. For patients, it is often the only place they can reach and store things while sitting in bed. Nurses use part of the table for setup and prep when they are in the room. And then, threes times a day it’s cleared to hold a food tray.

Research was a part of the project early on, and we worked closely with Kerrie Cardon, a nurse consultant with Herman Miller Healthcare. A photo survey she put together, for example, really helped us understand all of the ways [an overbed table] was being used.

How did this understanding translate into the design of Oasis?

We started by creating a top with a low-walled space at one end to better organize items, but without being too prescriptive and creating cup holders and niches for specific items. It’s easy to move things there when the nurse is working or the food tray arrives. On the column you sometimes find a box of some kind; we designed a small tray instead, which we left open for easy access and visibility. We added tall edges to the tray to keep things from falling off.

Our research showed that overbed tables are often pushed off to the side of the bed, so they’re running parallel to it, which makes it almost impossible for a patient in bed to reach the it. To address this, we added another storage space that floated above the main surface, allowing the patient to easily reach it.

We also spent a lot of time thinking about infection control and cleanability—two important issues in healthcare. The surfaces were designed to come together at a radius, which makes it easy for staff to clean.

The last thing we did was develop a really nice mechanism that allows the table to smoothly and easily move up and down.

Have you had any personal experiences that has informed your healthcare design?

No, I’ve actually been pretty lucky. That’s the irony of our products; we hope that you don’t have much contact with them.A lot of my experience has come from research and working on Nemschoff and Herman Miller Healthcare products.

What is the hardest part of designing healthcare furniture?

The hardest part is balancing all of the different needs of people who interact with a product. There are a lot of subtle things we consider—you appreciate healthcare furniture a lot more when you recognize these.

We believe products like Compass express the empathy we have with caregivers, patients, families, and administrators.

A new Herman Miller experience is taking shape as we put the final touches on our new Healthcare Experience Center. The new space, conceived as a holistic experience that begins the moment guests arrive, was a year in the making.

The Center and its adjoining spaces are the collaborative result of healthcare experts, architects, designers, nurse consultants, salespeople, our customer experience team, and many more—a true team effort.

Covering the entire continuum of care, the Center demonstrates Herman Miller Healthcare’s human-centered approach to product development and shows the range of solutions that Herman Miller Healthcare and Nemschoff provide.

Why the debate? Mirror-image rooms like the one below share plumbing chases and medical gas and electrical lines. That’s efficient from an architectural point of view.

On the other hand, same-handed rooms like the one below don’t share chases and lines. That adds about $3,000 to $5,000 to the cost of each patient room.

Even with this added cost, an increasing number of hospitals are choosing same-handed design. They’re doing because they believe that standardized same-handed design contributes to better process and workflow. Trouble is, there’s very little evidence to support this belief.

So the debate goes on. We think it’s a healthy debate because it focuses attention on the important role design plays in patient-room settings. It’s generating new research into the merits of same-handed versus mirror-image design, too.

This is all good, but in all the research and all the talk, let’s not lose sight of the people who deliver care. Too much standardizing in the name of efficiency—prescribing, for example, their approach (either left or right) to patients—may backfire if we don’t involve them in the discussion.

Photos 2 & 3 credit: HKS Architects

Think about crutches. Most of us don’t until we experience the difficulty and discomfort of using them. Crutches can damage nerves, arteries, and tissue, and it’s easy to slip and cause more pain or more injury.

Here’s a better way. It’s called Mobilegs, from Mobi, a Minneapolis-based designer of mobility products. Mobi, born out of Studio Weber + Associates, seeks to transform our perception and function of mobility devices like crutches, making them more comfortable, better-designed, and more customizable.

Mobilegs is so innovative, it was named Best of What’s New for Health for 2010 by Popular Science magazine, which reads, “Mobilegs takes the design to the 21st century with modern materials and careful attention to ergonomic factors (which should come as no surprise given that their inventor helped design the Aeron chair).”

That inventor is Jeff Weber, of Studio + Weber, who also designed Herman Miller’s Embody chair, Caper chair, and Envelop desk. “I work to humanize the relationship between people, products, and the world around us,” Jeff says. He was inspired by a 2005 foot injury that made him all too aware of the crutch problem. “The traditional crutch was not designed to accommodate the mechanics of the human body. Mobilegs does just that.”

It’s all about art. Kids’ art.

The idea, which originated with Dr. Bob Connors, head of the hospital, was to fill the facility with art created for and by children. And when the doors opened in January, more than 600 original creations, by nearly 9,000 West Michigan-area children, decorated the 14-floor facility.

“It was truly a community effort,” said Scott LaFontsee of LaFontsee Galleries/Underground Studios, who helped coordinate the huge effort that involved schools and other organizations as well as local artists who volunteered to help.

“When kids come to this place, they know it’s a children’s place,” said Dr. Connors, who was extremely pleased with the outcome.

Photo credit: Emily Zoladz, The Grand Rapids Press

The accreditation program provides participants with an understanding of how to incorporate findings such as the restorative effect of nature into healthcare building design decisions. For example, views of nature reduce a patient’s use of pain medication and reduce stress. We also know that private patient rooms reduce the spread of infection and improve communication between caregivers and patients and family.

Overall, I’m looking forward to putting this accreditation to work and becoming part of a community that focuses on the education and assessment of an evidence-based design process.

In fact, Doug Bazuin, a senior researcher with Herman Miller Healthcare and frequent contributor to Discover, recently had an article published by Hospitals & Health Networks about the Caregiver Goal Prioritization Pyramid. The article, called “The Pyramid of Caregiver Needs,” highlights the team’s research findings from nine hospital observations and 150 interviews.

Says Bazuin, “The pyramid reminds us to think through the multiple implications of any change or decision in a care giving process or environment. When we use the pyramid as an input into the design of a space or product, it can help to ensure we have considered all the variables and results in a better outcome for both the caregiver and the patient.”

“We know from our health insurance claims that a lot of people use urgent care or emergency room services for things that are not really emergencies simply because they don’t have a family doctor or anywhere to go for basic care,” says Mike Koppenol, Senior Manager, Employee Benefit Programs. “We thought if we offered some limited services at our three on-site clinics (previously used for work-related cases only) we could save money and also provide a better place to treat people for minor things such as sore throats, coughs, fevers, sprains, stitches, eye or ear injuries, that sort of thing.”

Using ER services for non-urgent care is not only very expensive—on average $450 versus $90 for a doctor’s office visit—it also ties up valuable resources that others may need.

Koppenol says the idea with the clinics, which are staffed by a physician, a physician’s assistant, and a nurse practitioner, isn’t to replace a primary care doctor, but to serve as more of a fill-in. “Employees need primary care physicians for annual physicals and for preventive care, and also so they have a medical ‘home’ to go to if something goes wrong. Our clinics can take care of the bumps and bruises that may come up in the meantime.”

Other large companies, from Toyota to Pepsi to Disney, are finding that on-site clinics are a great way to go; some studies show employers can save as much as 25 percent in employee health care fees in the first year alone, not to mention the savings in productivity when an employee doesn’t have to take 2-3 hours off for a doctor’s appointment.

He also is the co-founder of Continuum, an international design firm.

Here are seven questions (plus a half) for Gianfranco Zaccai:

1. What are you working on right now?

Well, I’m working on another project for Herman Miller. Like Compass, it’s in healthcare, which is a particularly compelling area to work in. When I first got out of design school, I began to focus on bringing a human touch to healthcare. That’s really vital.

There’s an overwhelming amount of technology in healthcare. Even doctors get overwhelmed by the evolution in certain disciplines. What gets lost is the human touch.

2. Which of your projects are you most proud of?

Years ago, I worked on another project for Herman Miller that never went to market, but it dealt with ways to allow people to stay at home as they aged or developed disabilities. We came up with a series of solutions for things like personal hygiene, for example. My own parents were aging at the time, so the development of the project came from observing them. When we were building prototypes, many people talked about how they needed something like it for their mothers—or for themselves. It never went into production, but those conversations indicated a need.

3. What inspires you? Where do you go for inspiration?

The way we approach any project is to get deeply into the context. So, with healthcare, we spend a lot of time in hospitals. We observe and talk to people—nurses, doctors, patients, cleaning staff. As a result, we are able to glean information that we’ve developed into a series of projects.

I also like to hike in the Italian Alps, especially the Dolomites. That’s a particularly wonderful place to be.

4. What work do you most admire by another artist or designer?

One guy I very much admire is Ettore Sottsass, founder of the Memphis collective. He was very pragmatic and was not afraid to step outside the bounds of what’s considered good design. His work was both rational and emotional at the same time.

I also admire Philippe Starck because he transforms everyday items into something you can experience in a different way. It’s very emotional design. I particularly like the flyswatter and the ghost chair.

And Renzo Piano, not only because he designs elegant buildings, but also because he incorporates elegant solutions, like bringing light into a gallery space, for example.

5. What would be your dream project?

To redesign the American healthcare system–the way healthcare is delivered, the way people collaborate, the way technology is integrated. We have a lot of Band-Aid solutions. Someone has to change the package.

And one-half: You’ve said that Compass is your favorite project. Why?

Compass deals with the sweet spot that I’m interested in—humanizing health care. If we’re successful, we will have created an environment in which providers can practice better healthcare and patients can feel that they’re well taken care of. Compass is a system that allows for efficient change, even if the hospital is 100 years old. It’s Utopian to think you can create the perfect environment for something when that something keeps changing.

6. What place in the world would you most like to visit?

Tibet, because of the mountains, but also because Asian art, architecture, and furniture is very appealing to me. I’ve been to other places in Asia, but not there.

7. What one thing do you want to accomplish before you die?

To make sure my children are headed in the right direction. Everyone has their own path to follow. I hope to do my part in preparing them to be good people and to achieve their dreams.

Photo via Syracuse University Magazine

Check out the latest Solution Essay to learn more about how Herman Miller helped two hospitals improve their processes.

The students did their own research, learning from interactions with office managers, nurses, physicians, and close family members who experienced these types of spaces and treatments.

“Research is a huge part of healthcare design. Herman Miller’s healthcare knowledge was a great assistance in our learning,” said student Melissa M. Suchowolec.

When asked to identify a key learning, there was consensus that the complexities and rigorous requirements of healthcare design were eye opening. The thoughtfulness and attention to detail would make them better designers of any space, not just healthcare.

Experiencing the students excitement, seeing their innovative designs, and hearing how this project had influenced their design thinking made this is a great collaboration and a meaningful experience for me and the Herman Miller team.

Here’s what they had to say about it:

Josh Boltinhouse
Stevens & Wilkinson, Columbia, SC
One thing that I took away from the conference was the incredible anti-microbial properties of copper. Most anti-microbial products simply don’t allow bacteria to multiply on them, but copper actively kills bacteria.

Amy Buller
Miles Associates, Oklahoma City, OK
Prior to the conference, I was aware of how important evidence-based design is to healthcare projects. What I learned at the conference, though, is that design implementations that do not produce assumed outcomes are just as important to discuss and share as those findings that do produce implicit results. I really appreciated the presenters who had the courage to share studies of multi-million dollar projects whose designs were assumed to be better for patients and staff but whose studies proved otherwise. These findings still help everyone in the design industry understand something new and should be shared.

Ryan Cameron
Visions in Architecture, Lincoln, NE
The one thing that stood out above all the sessions, demonstrations, and exhibits were the people. I cannot remember a conference of that size that I’ve been to where the people were as helpful, knowledgeable, and respectful as they were at HCD2010.

Seth Cantley
Liollio Architecture, Charleston, SC
The most important thing that I learned was healthcare sustainability is 20 times more demanding in consumption and waste than what the earth can handle. But several projects explored some great ideas that created incredible spaces, while giving back to the environment. Ideas like green public spaces in hospitals, operable windows for patients and power failure, and casework that can be easily switched as functions change are great examples that can revolutionize how we improve healthcare and the world.

Heather Greenfield
H+L Architecture, Denver, CO
One thing that I took away from this conference is just how important it is for architects and medical planners to collaborate with healthcare providers. After listening to sessions presented by medical professionals I learned that it is critical to have a medical staff member involved from day one to ensure that a well-functioning, highly technical and atheistically pleasing building is built. I believe that it the relationship should go further from just being an architect/client relationship to being a partnership between designers and healthcare professionals. I look forward to taking this insight and applying it to my career in healthcare design.

Julie Havens
HOK, Chicago, IL
The conference was great! I attended many lectures focused on master planning, emergency department, and international psychiatry design, which are my areas of interest right now, and was able to see many of the products we specify in our projects within the exhibit hall.

Kimberly Matteson
MEDNATIONAL, LLC, Fargo, ND
The most memorable thing that I learned from the conference is that it reinforced the path that I am on to be involved in healthcare architecture. The speakers at the sessions were so passionate about their research and concerned to find solutions to help patients, families, and staff. To be at the ACHA and AIA AAH meetings to see what true leaders in our industry are doing to improve the profession, be innovative, and create opportunities for others was inspiring to me and reinforced that this is what I want to be a part of.

Shruti Nathan
Anshen+Allen, part of Stantec Architecture, San Francisco, CA
As architects, interior designers and planners, what comes naturally to us is the ability to innovate, but the ability to innovate with the notion of empathy is what differentiates us from others and that’s what I am striving to achieve. The most valuable lesson I learned at the conference that I hope to adopt at every stage of my practice is to step outside myself and see the world from another person’s perspective. If we invent hospitals, we can bring the right change in them at any time!

Amanda Scott
Arkitex Studio, Inc. , Bryan, TX
The most memorable learning moment of the conference for me resides in a statement from an educational session on cancer facilities. The lecture began with the architect describing all of the wonderful design elements that the facility boasted. Then the facility representative follows by saying “What do you do with a skylight if there is a Melanoma patient sitting under it?” That statement really shocked me with the fact that a healthcare design is only as good as the support it lends the patient who is using it. I want to always remember that as I design in the future.

On a much more fun note, big feathers, sequins, some Elvis, and a little Frank Sinatra are quite memorable as well. So what happened in Vegas, will actually stay with me for quite sometime and add to my thoughts of better design for the future.

Congratulations to this year’s scholarship recipients and many thanks for sharing your experience with Discover!

The booth experience is one way we were able to provide insight into how Herman Miller Healthcare and its subsidiaries Nemschoff and Brandrud are bringing a new voice to healthcare.

Thanks to everyone who was able to stop by!

As part of the scholarship program, the company will sponsor the attendance of nine individuals at this year’s Healthcare Design conference in Las Vegas, November 13-16.

I thought it would be fun to catch-up with the scholarship recipients before the conference to find out what interests them about healthcare design and architecture. And, because creating a better world is important to Herman Miller, I specifically asked them how they think healthcare design and architecture can contribute to a better world.

Check out their thoughts about the subject:

Ryan Cameron
Visions in Architecture, Lincoln, NE
It is in a designer’s best interest to provide value to healthcare architecture—value created with better design through increased collaboration, new techniques and time for reflection. Future designers will need all three if they are to create a better world.

Seth Cantley
Liollio Architecture, Charleston, SC
Healthcare already has a great impact on the community, economy, and environment. How we grow and improve this network with better human scale connections, balance with nature, and comfort technology will show our true knowledge.

Josh Boltinhouse
Stevens & Wilkinson, Columbia, SC
By improving and influencing the built environment of those who are sick or have loved ones who are sick, we’re able to take some of the worst moments of the human experience and make them better, which, in my mind, makes for a better world.

Amy Buller
Miles Associates, Oklahoma City, OK
Creating a soothing, non-intimidating environment makes hospital and doctor’s visits more manageable, not a dreaded task. By aesthetically and functionally creating healthcare spaces that people want to occupy, we are, in turn, contributing to a better, healthier world.

Kim Matteson
MEDNATIONAL, LLC, Fargo, ND
I think that reducing the recovery time of a patient or creating a peaceful place for personal reflection or designing an efficient work space can be pretty significant in the person’s life that it touches. To make this world a better place involves creating a built environment that is thoughtful, innovative, and environmentally conscious and I’m grateful to be a part of it.

Julie Havens
HOK, Chicago, IL
Through an integrated design approach across the trades of master planning, programming, medical planning, interior design, and operations planning and implementation, healthcare design teams today are looking to implement environmentally conscious facilities that eliminate waste and accelerate healing.

Amanda Scott
Arkitex Studio, Inc., Bryan, TX
From the floor to the ceiling of any design and everything in between, every element, designed to physically support, visually uplift, and emotionally reinforce the actions within fully accomplishes a betterment for that entity.

Heather Greenfield
H+L Architecture, Denver, CO
I believe that great design can not only make a patient feel more at home while being treated, it can also improve the way a person feels while in the space. It is through innovative healthcare design that we can really make a difference in one’s treatment, recovery and life.

Shruti Nathan
Anshen+Allen, part of Stantec Architecture, San Francisco, CA
Better informed and innovative design solutions that respond to emerging new facts and advancing medical technology has proved to not only alleviate patients recovery time, but also use fewer drug treatments, help staff retention and comfort family and visitors during stressful times. Integrating this approach with a sustainable design results in healing spaces that are environmentally, economically and socially viable… and ultimately enriches lives.

After reading these responses, it’s clear that the future looks bright for healthcare design.

I heard several presentations about the latest research surrounding architectural and environmental design for health care environments, but one story from a keynote speaker has stayed with me. It focused on how our total health goes beyond our physical health, and how biophelia—a love for the natural world—plays a large role in it.

Interior designer Barbara Huelat, with Huelat Parimucha Ltd., asked the audience to think about the last time they really felt alive and energized. She then asked us to raise our hands if that experience was in nature and about 90 percent of the hands went up. Mine did, too.

Biophilia is a familiar concept to me and Herman Miller Healthcare, but Huelat’s story is a powerful reminder of the restorative power of nature.

Four key recommendations emerged from the report:

• Nurses should practice to the full extent of their education and training.
• Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
• Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.
• Effective workforce planning and policy making require better data collection and an improved information infrastructure.

Judging by the number of healthcare media references, The Future of Nursing report has started an important conversation about the role of nurses in providing care.

This report will also inform our conversations with customers about environments such as patient rooms and unit cores and how they will support nurses in the future.

Our current system of healthcare delivery is not organized to treat those with chronic conditions holistically. More efficient and cost-effective healthcare management calls for new approaches to our current model of siloed and fragmented care delivery.

Improving patient self-care, building teams of care providers that are accountable as a team, and introducing tools of technology to better communicate and share information, all guided by clinical leadership that wants to change, are required in order to shift from a siloed, fragmented system to an integrated, cooperative—and sustainable—one.

Photo via: workingnurse.com

Nurses are particularly aware of the effects of aging. The average age of U.S. nurses happens to be 46.8–the highest of all occupations in the world. Years of lifting and moving patients, and walking several miles during every shift, take a toll. Nursing also ranks among the top occupations for work-related back injuries—more than coal mining and manufacturing.

It is possible, however, to make nurse environments safer and more efficient. For example, the design of the central core unit—an area where nurses gather supplies, medications, check patient records, and consult with coworkers—is a good place to start.

Providing better lighting for reading prescriptions and locating medications, supplies, and equipment, and placing these items within arms length will reduce strenuous bending and reaching. Smart floor layouts also will reduce the amount of walking and give nurses more time to be with patients.

These steps will have a positive impact on the satisfaction and performance of nurses and address the particular realities of an aging workforce.

Healthcare environments can be very stressful and exhausting environments. And, because of the nursing shortage, there is a tremendous incentive to recruit and retain valuable staff. Creating healing environments for nurses is a powerful tool to aid that effort.

Places of healing and respite might be as simple as including discrete areas within the nursing unit to sit and take a deep breath. Sometimes, however, nurses just need a place to get away.

Creating a single occupancy respite room would allow staff to recharge the spirit, rejuvenate the body, and replenish the soul. No televisions or phones. Possible soothing features would include a lounge chair, aromatherapy, a water feature, dimmable lighting, and soft music.

These respite spaces must be thoughtfully and adequately programmed so that staff has room to breathe. And just like we provide access to natural light for our patients and families, we must also give our nurses this same caring treatment. Some staff spaces are being designed with access to outdoor space adjacent to the staff lounge. Having space to be outdoors where nurses can get a breath of fresh air can be very curative.

As designers of healthcare environments, we have a fabulous opportunity to be the change agents—and create healing environments that will help recruit and retain nurses.

When nurses are retrieving medications from the med room, they have to wait to access the automated medication dispensing machine. Storing medications at the patient room would eliminate that wasted time spent waiting and would enable nurses to spend more time with their patients.

And then there’s waiting for the nurse to return from the med room. While nurses are waiting to access the automated medication dispensing machine, patients are waiting for them. This isn’t a good situation, particularly if the patient is in pain.

Storing medications in the patient room is part of creating flexible and adaptable environments for nurses. We architects must create spaces for nurses that help them deliver quality care.

The traditional equipment cleaning process includes pushing it throughout the hospital to another department for cleaning. This means that a potentially contaminated item could be moving throughout the hospital. This isn’t a good idea.

Hospital staff already clean the patient’s bed, overbed table, bedside stand, and family furniture in the patient room. Adding equipment to the list would remove several steps from the equipment cleaning process. It also would improve operational savings and infection prevention rates.

Keeping and cleaning equipment in the patient room would significantly reduce staff travel distances, too, and eliminate hunting and gathering. And, it would allow nurses more time for their primary passion–taking care of their patients.